- Virtual behavioral health visits surged in the first half of 2020 as the COVID-19 pandemic exacerbated mental health needs, according to a new analysis by Milliman and Well Being Trust.
- All behavioral health visits, both in-person and virtual, oscillated within 20% of 2019 levels from January to August last year, even as in-person visits for other medical needs nosedived, Milliman found.
- Before 2020, 1% or fewer of all behavioral health visits were conducted virtually. However, in May through June last year, as much as 75% of behavioral health visits among commercially insured patients were done via telemedicine, and up to about half for Medicare beneficiaries in April through July.
Undertreatment of mental health concerns was a huge problem in the U.S. even before COVID-19, but the prolonged period of stress and loneliness, coupled with growing unemployment and economic uncertainty, exacerbated mental and behavioral health needs.
According to a report issued by the Centers for Disease Control and Prevention, symptoms of anxiety and depression rose considerably between April and June last year compared to the same period in 2019. Overall, 41% of respondents reported at least one adverse behavioral health condition related to COVID-19, including mental health symptoms or increased substance use.
Milliman's new report, based on claims data for 12.5 million beneficiaries between January 2019 and August 2020, found utilization of behavioral health services dropped quickly when COVID-19 first hit the U.S. early last year, in line with other in-person needs. However, behavioral healthcare fell less and recovered significantly more quickly than other medical services and approached or exceeded comparable levels from 2019 by the end of June.
Many consumers, regardless of coverage, turned to telehealth for their behavioral health needs, though the trend wasn't as strong with Medicaid beneficiaries, Milliman found. Between April and August, only 22% of all behavioral health visits were conducted virtually — much lower than in the privately insured and Medicare populations, suggesting potential access challenges due to insufficient broadband or technology.
The findings mirror a similar study released recently by the Rand Corporation finding affluent urban areas had the biggest increase in telehealth usage.
Despite telehealth's potential to reduce inequities in U.S. healthcare access, notably for rural patients who can live hours from their closest doctor's office, research has found that isn't always the case. The Rand study suggests that though telehealth use overall has indeed accelerated, that hasn't held true in rural areas.
The study, based on an analysis of more than 6 million insurance claims from job-sponsored plans, found metropolitan areas had roughly 50 telehealth visits per 10,000 people. That figure plummeted to just 31 visits per 10,000 people in rural areas.
Patients in wealthier counties had about 48 telemedicine visits per 10,000 people. That dropped to just 15 per 10,000 people in high-poverty counties.